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The management of fever and petechiae: making sense of rash decisions
1Department of Paediatrics, QEII Hospital, Howlands, Welwyn Garden City, Herts, UK. Pbrogan@ich.ucl.ac.uk
Archives of Disease in Childhood
|November 22, 2000
Insights
A study found 9% of children with fever and petechial rash had bacterial sepsis. New "ILL criteria" (irritability, lethargy, low capillary refill) are proposed for managing these cases.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Diseases
- Clinical Auditing
Background:
- Fever and petechial rash in children can indicate serious illness.
- Prompt identification of bacterial sepsis is crucial for timely treatment.
Purpose of the Study:
- To audit the incidence of significant bacterial sepsis in children presenting with fever and petechial rash.
- To propose novel clinical criteria for managing these pediatric patients.
Main Methods:
- Retrospective and prospective audit of 55 children.
- Data collection on presenting symptoms and diagnoses.
- Evaluation of clinical signs associated with sepsis.
Main Results:
- 9% of the audited children were diagnosed with significant bacterial sepsis.
- The study identified key clinical indicators for sepsis.
Conclusions:
- A notable percentage of children with fever and petechial rash have bacterial sepsis.
- The proposed "ILL criteria" (irritability, lethargy, low capillary refill) may aid in clinical decision-making.
Abstract:
In a retrospective and prospective audit of 55 children presenting to the paediatric assessment unit of a district general hospital with fever and petechial rash, 9% had significant bacterial sepsis. The "ILL criteria" (irritability, lethargy, low capillary refill) for the management of children with fever and petechiae are proposed.